Provider Demographics
NPI:1518225945
Name:FERGUSON, SONIA MARINES (LPC)
Entity Type:Individual
Prefix:MRS
First Name:SONIA
Middle Name:MARINES
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:SONIA
Other - Middle Name:
Other - Last Name:MARINES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:2460 W 26TH AVE
Mailing Address - Street 2:SUITE 450-C
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-5308
Mailing Address - Country:US
Mailing Address - Phone:720-863-4520
Mailing Address - Fax:
Practice Address - Street 1:2460 W 26TH AVE
Practice Address - Street 2:SUITE 450-C
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-5308
Practice Address - Country:US
Practice Address - Phone:720-863-4520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-23
Last Update Date:2016-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO11131101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO95185747Medicaid